HIGHLY EFFECTIVE LUNG DELIVERY OF A FULLY HUMAN MONOCLONAL ANTIBODY TARGETING PSEUDOMONAS AERUGINOSA FOLLOWING INTRA-NASAL ADMINISTRATION

A time-course study was performed to assess lung concentrations and bioactivities of a fully human monoclonal antibody (mAb) targeting Pseudomonas aeruginosa (PA) flagella type b (LST-007) following intra-nasal administration. Intra-nasal administration of LST-007 (5 mg/kg) resulted in high mAb concentrations (11 µg/ml) within the bronchoalveolar lavage (BAL) fluid at 15 min post-administration, which decreased to 3 µg/ml at 4 hr. In marked contrast, LST-007 concentrations in blood were 110 and 11 fold lower at the same time points. Scrutinization of BAL fluid demonstrated the presence of both intact and immunoreactive LST-007 towards PAO1 bacteria, which impeded bacterial motility, underscoring the maintenance of biological activity. These compelling data lay credence that intra-nasal and thus potential inhalation modes of administration might represent bona fide routes for a targeted mAb delivery to the lung environment and establishment of therapeutically effective concentrations. Such delivery approaches could help combat life-threatening, pneumonia infections caused by PA. KEY WORDS:Monoclonal antibody, intra-nasal, bronchoalveolar lavage; Pseudomonas aeruginos

Raising the Bar : The Risk Coalition : Leading Risk Thinking

Stakeholders look for assurance that organisations can continue to meet the Purpose and Viability requirements of corporate governance codes. Despite an increased focus on Audit Quality, stakeholders remain disappointed and confused that risk issues cause too many failures. This publication provides principles-based guidance for boards, board risk committees and chief risk officers in the oversight and assurance of all current and emerging risk types in support of opportunity achievement and the avoidance of failures and stakeholder harm. The Risk Coalition includes professional bodies, FS firms, Not-for-Profits and Regulators (as observers). Subsequent publications and support tools are available

Patient and health care professional views and experiences of computer agent-supported health care

Objectives To explore patient and health care professional (HCP) views towards the use of multiagent computer systems in their GP practice. Design Qualitative analysis of in-depth interviews and analysis of transcriptions. Setting Urban health centre in Dundee, Scotland. Participants Five representative healthcare professionals and 11 patients. Main outcome measures Emergent themes from interviews revealed participants' attitudes and beliefs, which were coded and indexed. Results Patients and HCPs had similar beliefs, attitudes and views towards the implementation of multi-agent systems (MAS). Both felt modern communication methods were useful to supplement, not supplant, face-to-face consultations between doctors and patients. This was based on the immense trust these patients placed in their doctors in this practice, which extended to trust in their choice of communication technology and security. Rapid access to medical information increased patients' sense of shared partnership and self-efficacy. Patients and HCPs expressed respect for each other's time and were keen to embrace technology that made interactions more efficient, including for the altruistic benefit of others less technically competent. Conclusions Patients and HCPs welcomed the introduction of agent technology to the delivery of health care. Widespread use will depend more on the trust patients place in their own GP than on technological issues

Emotional intelligence and affective events in nurse education: a narrative review

Objective To investigate the current state of knowledge about emotional intelligence and affective events that arise during nursing students’ clinical placement experiences. Design Narrative literature review. Data sources CINAHL, MEDLINE, PsycINFO, Scopus, Web of Science, ERIC and APAIS-Health databases published in English between 1990 and 2016. Review methods Data extraction from and constant comparative analysis of ten (10) research articles. Results We found four main themes: (1) emotional intelligence buffers stress; (2) emotional intelligence reduces anxiety associated with end of life care; (3) emotional intelligence promotes effective communication; and (4) emotional intelligence improves nursing performance. Conclusions The articles we analysed adopted a variety of emotional intelligence models. Using the Ashkanasy and Daus “three-stream” taxonomy (Stream 1: ability models; 2: self-report; 3: mixed models), we found that Stream 2 self-report measures were the most popular followed by Stream 3 mixed model measures. None of the studies we surveyed used the Stream 1 approach. Findings nonetheless indicated that emotional intelligence was important in maintaining physical and psychological well-being. We concluded that developing emotional intelligence should be a useful adjunct to improve academic and clinical performance and to reduce the risk of emotional distress during clinical placement experiences. We call for more consistency in the use of emotional intelligence tests as a means to create an empirical evidence base in the field of nurse education

Point-of-care method for total white cell count: an evaluation of the HemoCue WBC device

Point-of-care testing (POCT) is becoming an important adjunct to haematology laboratory practice. An important component of the blood count is the total white cell count (WBC). Previously, this required laborious microscopic cell counting, but it can now be performed by means of automation; however, in many under-resourced countries, costly automated counters are only available in very few central hospitals. Moreover, neither method is practical in most POCT situations. The HemoCue WBC has been developed as a simplified alternative method, consisting of a reagent pre-loaded disposable cuvette together with basic image analysis technology. This report describes an assessment of its utility. The WBC of 500 routine blood samples from the hospital were tested in parallel by the HemoCue WBC and by a reference analyser to assess accuracy and utility of the former. The tests included precision, linearity, type of blood sample and anticoagulant and potential interfering substances in blood specimens. In the tests for accuracy, 192 of the 200 showed percentage difference from the NEQAS reference of <10% whilst the remaining eight samples differed by <12%, thus meeting the requirements of Clinical laboratory improvement amendments (CLIA)-88 regulations. Of the samples tested with potential interfering substances only those with >2% normoblasts or reticulocytosis showed significant differences from the reference measurements. The HemoCue WBC is reliable for WBC counts within the analytical range of 0.4–30.0 × 109/l, except in samples where there are significant numbers of normoblasts or reticulocytes. It is simple to use and provides a valuable advance in the facilities available for POCT in haematology

From Macroscopic to Microscopic: Experimental and Computational Methods to Investigate Bio-tribology

Tribology is an important factor (among other factors) during biological interactions of devices and tissues. The paper discusses how new computational and experimental methods can be used to understand and improve the design and development of medical devices at macro and micro scales to sustain life beyond 50 years. We have used pre-clinical experiments and computational methods to understand interactions between orthopaedic implants at the macro scale. The computational model has been validated with experiments. Now this computational model can predict damage in implants for different patients. One such application was successfully tried and tested in collaboration with University National Autonomous Mexico. This methodology can be used in future to design patient specific, affordable (using 3D printing) and robust implants which will be useful for developing countries like Vietnam, India and Mexico. Improvement of catheter designs is important to reduce damage to the internal tissues while being used for cardiovascular problems. We are developing new experimental techniques (in micro scale) that can be used to understand the interaction of cells with the catheter material. These will help reduce the hospital costs incurred during longer stay of the patients admitted for cardiovascular related problems

Task analysis for error identification: Theory, method and validation

This paper presents the underlying theory of Task Analysis for Error Identification. The aim is to illustrate the development of a method that has been proposed for the evaluation of prototypical designs from the perspective of predicting human error. The paper presents the method applied to representative examples. The methodology is considered in terms of the various validation studies that have been conducted, and is discussed in the light of a specific case study

Faith in the Republic: A Frances Lewis Law Center Conversation

This is a spontaneous conversation discussing Hauserwas’ singular political theology in response to Levinson and Tushnet’s constitutional jurisprudence. It developed into a highly interesting debate concerning constitutional faith. This conversation was recorded at Washington and Lee’s Law Center on December 11, 1987

Faith in the Republic: A Frances Lewis Law Center Conversation

This is a spontaneous conversation discussing Hauserwas’ singular political theology in response to Levinson and Tushnet’s constitutional jurisprudence. It developed into a highly interesting debate concerning constitutional faith. This conversation was recorded at Washington and Lee’s Law Center on December 11, 1987